Abnormal Smear Test

Smear tests are offered to a large percentage of women in the UK at 3-yearly intervals. Being told that your smear test is not normal may cause distress and fear, however in the majority of cases it will just mean either repeating your test a bit sooner than normal or further investigation at the hospital.

Having an abnormal smear does not mean that you have cancer, or are going to develop it in the future.

Now that the National Screening Programme is well established, cervical cancer is extremely rare in women who attend regularly for smears.

Why do We Have Smear Tests?

On a global basis, cervical cancer is the second most common cancer after breast cancer, accounting for about 15% of all cancers in women. It is known that before cancer of the cervix develops, there are 'early warning' changes in the cervix which are detectable by taking a smear.

Once detected, the progression to cancer can be halted with the appropriate treatment. Screening and treating before cancer develops has led to a fall in the number of cases of cervical cancer by almost one half. Smears are offered to all women aged 20-65 years, and women over 65 who have not had preceeding normal smears.

The smear test samples the cells on the area of the cervix where cancer begins and a pathologist looks at these cells under a microscope, seeking out unusual-looking ones. From this the pathologist gives a result to your GP stating the degree of abnormality, if there is any.

What is Seen in a Normal Smear?

A normal smear will have a sample of the cells from the area of the cervix known as the transformation zone. This is where the soft lining of the inner cervix meets the toughened lining of the outer cervix which sits in the vagina. The transformation zone is where changes which might lead to cancer first occur. After the doctor or nurse has taken the smear, they will wipe the brush or spatula onto a glass slide, ready for reading by the pathologist.

What is Meant by an 'Unsatisfactory' Smear?

This result means that the pathologist could not satisfy himself that he has a good sample from the cervix. This might be because of too much blood or mucous being present, contamination by foreign material or inflammatory cells indicating a reaction by the body to infection or trauma.